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Senior Health Care Insurance on the Web
by william pritchett

When a good friend of mine inquired where he could
obtain information about medical insurance for his
out-of-state, elderly mother, I told him to try the

He reported back to me about a week later, in
desperation: "I am giving up, I am too confused." He had
taken on an overwhelming project with his widowed mother,
living in another state. As the only child, and following
the sudden death of his father, it was his responsibility
to care for his mother.

In this world of technology, the family unit is often
living in different geographical areas and the family
members are usually quite involved with their own lives,
careers, and families. In addition, when both parents are
alive, often one or both parents are quite independent and
do not require a lot of assistance. As time goes on things,
of course, change, and sometimes change very suddenly.
There can be a crisis, with regard to the health care needs
of one or both aging parents.

With our baby boomers facing this problem in ever
increasing numbers, and with the information highway in
full bloom, there is a definite need for planning.

Protecting your parent's assets and health is a huge and
daunting undertaking, which requires a tremendous amount of
education and practical application. Our seniors face many
diverse responsibilities upon reaching age 65. To name just
a few: Estate planning, taxation, Medicare, social
security, wills, insurance, and various other legal and
financial matters. All of these different areas require
expertise from accountants, lawyers, estate planners,
insurance agents, home brokers, financial advisors, and

The Internet is a good starting point for most people to
find resources for questions and solutions for your
problems. There is, however, no replacement for good solid
intelligent advice from an expert.

Twenty years ago, insurance for elders was sold by "senior
insurance specialists", with just a handful of companies in
each state. The programs were most often Medi-gap or
Medicare supplemental policies, which covered the expenses
not covered by Medicare, including hospital and doctor
deductibles, durable medical devices, and non-approved
Medicare costs. Ironically these specialists did not sell a
lot of nursing care policies, even though Medicare paid a
national average of less than 2% of these expenses. With
the advent of "financial and estate planning" and more
insurance companies entering this market, a more broad and
diversified product line became available to agents,
brokers, planners, and seniors.

Part of this new diversification was the "home health care
plan", sold by itself, and in conjunction with senior
health insurance products. The appeal of the "home health
care policy" was that a senior could stay at home and still
receive medical and custodial benefits, allowing a person
to recuperate in the comfort of their own home.

This was the answer to a huge problem. The last place an
older person wanted to go was a "retirement home", or "rest
home", or, God forbid, the "nursing home." It appeared that
seniors could now rely on this new innovation without worry
of having to move out of their home environment in the
event of a health problem.

As with most things," if it is too good to be true".... The
home health care policy is no exception. The problem is,
there is not enough coverage for a lengthy illness or
recuperation time. The fact is, the new trend is toward
an "all in one" type facility, allowing for a variety of
levels of care all in one location. In other words a senior
could start off with little or no health care concerns in
an independent, less expensive area, and then go to an
assisted living, or nursing care facility, all within the
same compound.

A "nursing home" requires a nurse on the premises 24 hours
per day, assisted living is just eight hours. The
advantages to this are financial. The patient or senior is
only charged according to the care level required during
the time he or she is admitted to that facility. Another
benefit is it alleviates a lot of planning because the care
is delivered, as it is needed. The medical attention is
available to all residents regardless of their current

Some people are offered a lifetime package, which covers
their care for the rest of their life, regardless of their
current age. It also allows for social outlets to an
otherwise somewhat isolated group. On-line shopping
services have become a huge business. It is definitely here
to stay and many insurance policies are purchased from
Internet quotes and on-line applications.
There are literally hundreds of thousands of insurance
agents and brokers advertising on the Internet. Most of
them will provide instant on-line quotes and even
applications for the potential insured. I highly discourage
a layperson to purchase insurance in this fashion. A little
knowledge can be dangerous.

The federal government has mandated to all states through
legislation, the standardized senior health insurance
policy guidelines, which are governed and regulated by each
state insurance department.

There are plans for almost every level of health. Some are
designed and priced for a less than healthy individual.
Others are for a person with minimal health concerns. . The
whole concept of insurance is to provide protection
for "unanticipated" sickness or injury, especially
catastrophic expenses, which would devastate a person's net
worth. The more small expenses a person is willing or able
to pay (self-insure), the lower the rate. I recommend this
strategy when evaluating your insurance options.

Another consideration when reviewing various insurance
plans is to look at the company itself. How long has the
company been selling this type of insurance? Do they have a
lot of complaints filed with the local department of
insurance? Are the rates stable? Does it pay claims on
time? Service? Most agents talk about the rating. These
ratings are as follows: A+, A, A-, B+, B, B-, C+, C, C-,
or "not rated".

Do not be fooled by rating alone. It is good to have a high
rating, but it is far better to have a company that has
longevity, stability, innovation, service, and expertise.
The problem is that some companies enter into a market and
quickly leave without explanation. This does not give
security to the policyholder.

The most important consideration should be a review of the
profit/loss ratio for that product. This will establish
stability, and longevity in the market. An insurance
company with a moderate profit in a particular line of
business will remain in that market. On the other hand, a
company with losses will make changes and possibly even
withdraw. This is information not normally available to
Internet users.

Before entering into an insurance contract, the senior
person, the family, and other advisors must be realistic,
and a careful evaluation of the entire picture must be
examined. The age, the health of the senior, the financial
resources, the personality and attitude of the senior, and
most importantly the desires of the senior, should all be

Early planning is important, as qualification becomes
increasingly more difficult as the applicant's health
declines. The senior health care market is complex. I will
offer some words of advice to attempt to alleviate
potential pitfalls. *Choose a well-informed, seasoned, and
service oriented agent or broker to assist your decision
making process. The professional can offer invaluable
information, but do not be afraid to ask a lot of questions
and even get a second opinion. *Do not wait until your
parent or loved one is sick, or injured. Plan ahead and
take the time needed to cover all the options. *Choose an
experienced insurance company. A Company that has been in
the marketplace for a significant time and has maintained a
balance of rates and benefits and sound risk selection with
moderate rate increases over time is your best bet. *The
plan should be flexible, with a broad range of options and
benefit selections to the insured. There should be no
tricks, or complicated language for the coverage. An
incredibly low rate is a red flag for trouble in the
future. *Do not rush or be rushed by an over aggressive
sales person.

This policy will not be inexpensive and will need to be
read and reviewed for a clear understanding of the
contents. This is one advantage to the Internet. You are
allowed to read indefinitely before you act.

A long-term care program, with or without insurance
coverage, will only work if the senior has input into the
care selection process. If there are any questions about
the accreditation of a facility please call the "Continuing
Care Accreditation Commission at 202-783-7286.

William Pritchett
Empire HomeCare Resources, Inc.

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